Department of Vascular and Endovascular Surgery, Ruprecht - Karls University Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Eur J Vasc Endovasc Surg. 2010 Jun;39(6):693-9. doi: 10.1016/j.ejvs.2010.03.018. Epub 2010 May 10.
To analyse early and midterm results of thoracic aortic endografting (TEVAR) in the aortic arch.
Between January 1997 and February 2009 178 patients received TEVAR in the aortic arch at our institution. This population was subdivided into four groups according to the proximal landing zone (LZ) classification in the aortic arch by Ishimaru et al. and a retrospective analysis regarding perioperative mortality, morbidity and endoleak formation was performed.
The overall 30-day mortality rate was 14% with no statistical significant difference between LZ's 0-3 (p=0.274). Renal insufficiency (hazard ratio (HR) 2.5; p=0.0119), age >75 years (HR 3.1; p=0.0019) and emergency procedures (HR 8.9; p < 0.0001) were independent predictors of death. There was no significant difference regarding type I (p=0.07) or type III (p=0.49) endoleaks between the proximal LZs, but a significant difference regarding the development of type II endoleaks (p=0.01).
The present study showed no influence of the proximal LZ on perioperative mortality and morbidity rate. Furthermore it did not influence relevant (type I/III) endoleak formation.
分析胸主动脉腔内修复术（TEVAR）在主动脉弓中的早期和中期结果。
1997 年 1 月至 2009 年 2 月期间，我院对 178 例患者在主动脉弓中进行了 TEVAR。根据 Ishimaru 等人的主动脉弓近端着陆区（LZ）分类，将该人群分为四组，并进行了围手术期死亡率、发病率和内漏形成的回顾性分析。
总体 30 天死亡率为 14%，LZ 0-3 之间无统计学显著差异（p=0.274）。肾功能不全（危险比（HR）2.5；p=0.0119）、年龄>75 岁（HR 3.1；p=0.0019）和急诊手术（HR 8.9；p<0.0001）是死亡的独立预测因素。近端 LZ 之间在 I 型（p=0.07）或 III 型（p=0.49）内漏方面无显著差异，但在 II 型内漏的发生方面存在显著差异（p=0.01）。
本研究表明近端 LZ 对围手术期死亡率和发病率无影响。此外，它对内漏的形成（I 型/III 型）没有影响。
